It is proposed to establish a facility and program for stroke prevention and acute stroke management, with an emphasis on the former. This will encompass outpatient and inpatent hospital servies with the primary study group consisting of patients wth transient cerebral ischemic attacks. Studies will consist of comprehensive clinical and laboratory evaluation of patients with impaired cerebral circulation. Assuming a frequent occurrence of precipitating factors in strokes, in addition to the underlying atheromatous vascular disease, studies will be directed to the detection of such factos, e.g., cardiogenic, ventilatory, hematogenous, or vascular. The establishment of such a facility will provide a means to develop and validate standard diagnostic and management protocols for such patients, develop screening procedures useful in general medical practice for detection of patients most at risk, and increase the general awareness in the medical community of problems relating to cerebral vascular disease. The facility will provide a training ground for physicians, nurses, and technicians in methods of evaluation and management. It will provide a concentration of patients with cerebral vascular disease and physicians with expertise in its evaluation and management. The facility will be a ideal framework within which to carry out specific research projects related to the problem of cerebral vascular disease and a center for dissemination of information to the medical community.